Foundation year one training in neurosurgery: achieving competency a 5-year review

Abstract

Introduction: F1 doctors are a rare breed in Neurosurgery, featuring in only 4 out of 40 UK centres. It is widely perceived that Neurosurgery would only provide a highly specialised experience for F1s, limiting the opportunity to achieve the core practical and clinical competencies as highlighted by the United Kingdom Foundation Programme (UKFPO). Additionally, Health Education England have increased the number of community placements such as General Practice and Psychiatry further limiting F1 placements offered in specialities like Neurosurgery.Aims: We sought to acquire the views, experiences and true perspectives of training from F1 doctors in our neurosurgery centre. Importantly, we wanted to determine whether Neurosurgery provides sufficient opportunities to achieve mandatory core foundation competencies.Methods: We invited all F1s (27) to complete a secure-web based online questionnaire comprising nine domains of training.Responses: We had an overall response rate of 96%. Ninety-six per cent of our F1s valued this placement, gaining skills that could be transferred to other specialities. Eighty-eight per cent found the post to be of similar or greater value in comparison to their other F1 posts and 66% would recommend this post to others. Ninety-two per cent of F1s felt they were adequately supervised and regular informal feedback was offered in order to ensure acquisition of core competences. Fourty-four per cent of F1s were involved in post-graduate academia. All trainees attended their mandatory F1 teaching although attendance to additional departmental teaching was limited.Discussion: Trainees found that Neurosurgery provided a generalised exposure not a specialised one. Ninety-two per cent felt Neurosurgery had provided sufficient educational opportunities to achieve their required competencies. Importantly, all trainees managed to achieve their core generic competencies. F1 placements in Neurosurgery are highly beneficial to both trainee and service. The placement provides more than sufficient educational opportunities to help meet mandatory training requirements. F1 doctors also augment the number of junior doctors supporting the neurosurgical service.